Conference moira::parenting_v3

    When my daughter went in for orthopedic surgery she was only a month
    old, so I didn't have to deal with the emotional issues.  However, the
    hospital made a mistake regarding the hour I needed to be there, so I
    sat for 3 hours in pre-op and listened to surgical team after surgical team
    prepare the kids and (in some cases) administer the first round of
    anesthesia.  Surgical nurses, surgeons, and particularly
    anesthesiologists spoke with kids.  In fact, there were some kids who
    were able to choose their own inhaler masks; they were scented
    watermelon, strawberry, bubble gum, etc.  
    
    If you're taking your child to a pediatric hospital the entire staff
    will be geared toward treating children and the emotional issues that
    go along with that.  Also, most hospitals have a pre-surgical program
    for kids to answer their questions, help allay their anxieties, and
    just generally acquaint them with the hospital.
    
    There are also a bunch of books that deal with surgery.  Fred Rogers
    has one, as do the Berenstain Bears.  Check with any decent bookstore.
    
    Good luck to your nephew.  It's been my experience that the parents
    suffer more than the kids.
    
    Regards,
    LZP
    

    	I spent lots of time in the hospital as an adolescent\young teen
    after being hit by a car.

    	I still carry some of the scars of those first hospitalizations,
    many in the form of flashbacks and nightmares.

    	In hind sight, the things that I wish they (medical staff and my
    parents) had told me were:

    1. Yes, it was going to hurt. (I had lots of orthopedic surgery and
    they kept telling me that it wouldn't hurt. Sorry but when you are
    breaking bones and cutting through tissue, that's going to hurt. I was
    left in the situation where I doubted what was real, *I* hurt like hell
    and yet the adults were saying that it didn't hurt.)

    2. When it hurts too much, tell someone. (I was told to be a brave girl
    and bite the bullet and all of that other stuff that people say to
    others when *they* can't stand your pain.)

    3.I was going to have a scar. (when they finally took the bandages off,
    I was just not prepared to see a large sutured incision running down my
    leg, it was very frightening and I worried about "popping open")

    4.I was not in the hospital because I was bad. (my parents couldn't
    deal with the fact that I had gotten hit by a car (I was on a
    bicycle) and so they turned it around and blamed me for causing the
    accident. Be careful, how you handle your guilt about a child's pain.)


    5. I was not going to feel the operation. (I didn't know anything about
    surgery and also worried about waking up and feeling the cutting, in
    fact I may have woken up during one of the operations because I have
    very vivid memories in the form of dreams about seeing and hearing the
    operation, waking up is rare though, for the most part, I wish I had
    been told that I would be asleep during the operation and that I would
    wake up later *in another room* and that I might be hurting then.
    	Hospitals are scary places there is no doubt about it.
    	
    	But  now I know how to make the experience more comfortable (I
    still have to periodically go in for surgeries). This is what I do as
    an adult (might work for a child also) to get through the experience.

    1. I bring my own night clothes (not really necessary for day surgery)

    2. I bring my stuffed bunny who is rather ragged because I have cried
    many times into it and I have held it very, very, tight when the pain
    was bad. A stuffed animal is a MUST for ANYONE in the hospital.

    3. I try to make the surroundings familiar, I bring tapes, favorite
    perfumes (light scent, don't want to annoy the roommate), books,
    cartoons, things to keep me busy.

    4. In general I try to take control of what I can (granted there are a
    few things that are beyond your control, that's why you are there).

    	In summary, I think that you should be truthful with your kids,
    that's all I wanted. Answer any questions with the truth and not *What
    you as an adult want to hear*, on the other hand, don't go out of your
    way to scare the child either.

    	Hospitalizations are scary but they can certainly be made less
    traumatic.

    			Wendy

Just off the top of my head, a couple of things.  I hope I'm not too late.

First, the hospital gave our daughter a demonstration, with a doll, of all the 
tubes, IVs, etc. that would be sticking out of/into her, when she woke up.  

Second, we had a set of "hospital" figurines (Playmobil, I  think) -- with 
nurses, doctors, patient, operating table, etc. so we (and she) could act out 
what would happen.

Clay

    
    
    	I have also seen those play figurines (some even come with crutches
    and a bedpan) and thought that they would be very helpful in
    explaining to a child what happens in the hospital. I also think that
    they would be handy in explaining hospitals to a child should a family
    member need to be in one.
    
    			Wendy

    I would definitely be honest with the child, especially about the
    "pain" part, like a previous note mentioned. It is okay to say a
    procedure will hurt and it is okay for the child to tell people it
    hurts. Remember there is a whole post-operative "scene" as well. I had
    some surgery and remeber becoming conscious rolling down the hall to
    the ICU. It was scary because it was not the last place I remember.
    Luckily my family was there and it really didn't matter but I was much
    older. 
    
    Tell the child when he wakes up, that parents may not be the first
    person he sees. It's not because you are not there, it is because of
    where he was woken up (and you aren't allowed in the operating room).
    
    Tell the child that he may/will be uncomfortable after the surgery. If
    they need to put a tube down his throat, he may have a sore throat.
    Where the incision is, will ache (but you can give him pain relievers
    as prescribed). Definitely ask the doctor about any other
    post-operative side affects. I threw up blood and was scared to death
    that they had totally cut up my insides when it was just a result of
    blood dripping down my throat (sorry to gross anyone out!!). But no one
    told me. I would think saying to a 3 year old "after you wake up, it
    will be all over" is a great dis-service to the child!!!
    
    Best of luck.
    Andrea

    Thank you for the replies so far.  I think the hospital play set sounds
    like a good idea.  I'm going to run out at lunch and see if I can find
    one.  I'll also look for the Mr. Roger's book -- Brian loves him!
    
    We have told Brian that his "cut" will hurt some after the operation,
    but that it shouldn't be too much worse than any other cut.  (I believe
    it's going to be a small incision right in the crease where his leg
    meets his body.)  Does that sound right?
    
    I haven't been under general anethesia (since tonsils at 2) so I'm not 
    sure what to say about that.  What does waking up feel like?  I've heard 
    that some people cry when it's happening.  Does it hurt?  Is it just scary
    and disorienting?
    
    Letting him know that his parents may not be the first one's he sees
    when he wakes up sounds like a good idea.  They intend to be right
    there but I guess you never know.
    
    Thanks again for all of the suggestions!
    
                                                     Tracy

    
    
    	I guess this must be a hot topic for me, I keep coming back to it.
    Obviously I feel very strongly about this. Keep this in mind when you
    read my responses.
    
    	Anesthesia is difficult to describe, when you get it,  you feel
    like you are floating higher and higher and then there is nothing,
    absolutely nothing, you wake up in the recovery room with no sense of
    time. I have been out for up to seven hours and it had not felt like
    anytime had passed. I imagine that that concept might be more
    dis-concerting for an adult than for a child. I don't recall it
    bothering me until I was older and had a sense of time and control.
    
    	Waking up from anesthesia is very disorienting. You usually wake up
    in another room and it shakes your sense of reality. "hey wait a
    minute, I don't remember being in this room, how did I get here? WHAT
    ELSE WAS DONE TO ME?"
    
    	You are usually very confused (although with practice it gets
    better) sometimes you vomit, sometimes you cry, sometimes you feel pain
    immediately, sometimes not. I've had 16 operations and each time has
    been different.
    
    	Another thing that I remembered is that you are only allowed to
    wear a johnny in the O.R. you are not allowed to wear underpants (this
    of course makes sense now, but as a child it was very disconcerting, if
    you are operating on my leg why can't I wear underpants?). I was very
    embarrassed and wondered if I would be "exposed" during the surgery.
    This, of course, may not be an issue for a three year old, I don't
    know. I would think that a simple explanation that it is okay to not
    wear underpants and that work will be done near his genital area would
    be prudent. 
    
    	Hospitals are now starting to realize that children can be very
    traumatized by hospital stays and there is usually a nurse or trained
    professional who is willing to work with the parents to make it less
    difficult for all involved.
    
    
    			Wendy

Maggie had an emergency apendectomy at 4 1/2.  When she went into 
surgery, her Snuffles went with her and they put a surgical mask on
his face so he would look like all of the other people around her 
and the masks wouldn't be quite so scary.  Her operation was at Mass 
General which has a terrific pediatric ward and pediatric surgical 
staff.  They went a long way to keep both Maggie *and* her parents 
from loosing it along the way.  As soon as she was coming out of the 
anesthetic, they brought us into recovery so she saw our faces within 
a minute of waking up.

After this surgery (no time before) and before her other tests (UTI 
problems) Harvard Community Health had her talk to a child life 
specialist who was absolutely terrific at getting her to talk about 
her fears and explaining what had happened (or was going to happen).
This was invaluable.

Best to your little guy and to you - its scary for both.
Norma

    I would definitely see what the hospital has to offer as far as
    advice. Maybe you could do a visit with the anestheologist before the
    day of the surgery and then be able to discuss it "in private" after.
    
    Find out the procedure for "putting" your son under. Since hernias are
    relatively common in children, I assume there is no reason for major
    doses of anesthia. He may actually be wheeled into the operating room
    totally conscious. The lights and equiptment might scare him and you 
    won't be there either. They might actually give him a "sedative" (if 
    you see a metal syringe come out you know it was morphine or something) 
    prior to being moved.  
    
    Find out the procedure for waking the child. They may actually bring
    the child out of OR and into recovery still under and bring them out so
    the parents can be there. If you think your child is afraid of waking
    up and being disoriented, stress to the staff that you want to be there
    as soon as you can. I assume that he won't be put heavily under but you
    never know how each person will react to drugs. My grandmother
    holusinated (sp?) every time she came out of anesthia. I remeber having
    to prove to her that bolt in the ceilig was not a spider but she kept
    making me climb on a chair to kill it and got quite upset when "more"
    kept coming back!!
    
    I think you should ask all your questions well in advance of the
    surgery so your son has time to "digest" the process and you will be
    able to discover his areas of concern. 
    
    Andrea

    
    I would also try to make clear that neither you (the parent) nor the 
    doctors can be sure exactly what will happen, and there may be surprises.
    This comes from an adult experience.  I had four wisdom teeth out under 
    anethesia (as an out patient).  It turned out the I.V. was not in quite
    right, and half way through I became conscious without the staff realizing 
    it for a bit (though without pain).  If I had been a kid, and been taught
    a specific scenario about waking up after it was over, I would have
    probably been absolutely terrified.  There are many other unexpected
    turns events can take.  So, tell them what is "likely", not exactly what 
    "will happen."  
    
    		- Bruce
    

    My daughter just had day surgery to remove a rather large birthmark
    (hemangioma) from under her chin.  We were as honest with her as
    we could be about everything that was going to happen, and it worked
    out very well.  It is quite common, from what I gathered talking to 
    the anesthiologist, that children will get sick (vomit) or at least
    be very nauseous for a while after waking up from the anesthesia.  In
    Sarah's case, she vomited for about 3 to 4 hours afterwards.
    
    Best wishes to you all,
    
    Valerie

    My son (now 3 1/2), at 2 years old had his adnoids out and tubes
    put in his ears.  It was scary - I think the worse part was when
    they take the child out of your arms and you hear him screaming
    down the hallway.  
    
    We explained it to Alex thru Mr. Rogers book (can't remember the title)
    and told him it would be uncomfortable when he woke up, and that mommy
    or daddy cannot be there when you wake up (Hospital rules).  He came
    thru with flying colors.  Only problem was the IV in his hand, and he
    had to keep the IV in, until we left the hospital (about 3 hours). 
    Neither my husband nor I explained the IV to him before the surgery.  I
    wish we had!  He was completely ticked off!!!
    
    Only complication was the vomiting, which lasted about 3 hours.  Good
    luck and just tell the child the truth, kids can handle it better than
    adults!  I broke down when they took him into the operating
    room.....but Alex never saw me, thank goodness!!
    
    Good luck, kids are tough little buggers!

Brian's hernia surgery is over and we all survived it pretty well.  There
were a couple of problems though...

My sister had asked about the pre-op procedure and was told that Brian
would be given a shot while he was still with them so that he would 
be groggy when they took him to the OR.  It turns out that he didn't
have to have a shot after all.  The good news is that it was the shot that
Brian was most afraid of, so not having it was good.  He went off to the OR
with the his stuffed leopard without a problem.  The bad news is that he
worried unnecessarily about the shot for two days.

The post-op procedure was more of a disaster.  My sister was told that she
couldn't be in the recovery room, but that as soon as Brian started to wake
up they would come for her.  They said that he would still be groggy and
he wouldn't know the difference.  Wrong.  Lorri heard Brian screaming and
ran into the hallway to see him being wheeled up the hall.  He was sitting
in one of those baskets they put the newborns in.  He was completely alert
and hysterical.  Maybe people come out of anethesia differently, but groggy
was certainly not the way for Brian.

It took about 20 minutes to get him calmed down (though it seemed like
forever).  He was very sensitive to everything.  He couldn't stand having the
IV in his hand and was trying to pull it out, he was trying desperately to get
away from the pole holding the IV bag, and he couldn't stand to have anyone
touch him.  He wanted to sit on my sister's lap, but didn't want her hands 
on him.  Luckily, there was a big, deep rocking chair in the room and she 
could sit far enough back to not have to hold him.  It almost broke my heart 
when he touched his bandage, looked up at us with big, teary eyes and said "I 
hurt so much".  As hard as it was for us, I'm not sure I agree with "it's
harder on you than on them".  He was pretty miserable.

Once the anethesia wore off, he calmed down quickly.  We got him to drink some
juice and eat a popsicle so that he could have some tylenol and get rid of the
IV.  That helped a lot.  After that we read books with him for about an hour
and then he felt well enough to take me to the playroom to see the trucks
he liked.  They released him early (11:30 -- surgery was at 8:15) because
he was doing really well -- it was great to get him home.

He spent most of the afternoon on the couch after eating *lots* of soup for
lunch.  We watched a Mr. Roger's video and Peter Pan twice each before he
finally fell asleep.  Once he woke up, he was his old self again.  He was
playing the game of standing on the couch to see how far he could make his
socks fly, and he kept forgetting not to jump off after them!

It was a long and tiring day for everyone, but I'm thankful that it went as
smoothly as it did.  My sister is going to write to the hospital about the
problems after the surgery.  It seems like something could be done to allow
parents to be with small children when they wake up.  There's no guarantee
that Brian would have been any less upset if Lorri had been there from the
start, but it might have helped and certainly wouldn't have hurt.

Thanks again for all of your suggestions and support before the surgery.

                                          Tracy